Parotid enlargement

Parotitis is an inflammation of one or both parotid glands, the major salivary glands located on either side of the face, in humans. The parotid gland is the salivary gland most commonly affected by inflammation. Parotitis is an inflammation of one or both parotid glands, the major salivary glands located on either side of the face, in humans. The parotid gland is the salivary gland most commonly affected by inflammation. Dehydration:This is a common, non-infectious cause of parotitis. It may occur in elderly or after surgery. Acute bacterial parotitis:is most often caused by a bacterial infection of Staphylococcus aureus but may be caused by any commensal bacteria. Parotitis presents as swelling at the angle of the jaw. Bacterial parotitis presents as a unilateral swelling, where the gland is swollen and tender and usually produces pus at the Stensen's duct. This pus is usually sampled and the bacteria within are identified. Common causative bacteria are Staphylococcus aureus, Streptococcus pyogenes and E coli. It is associated with poor oral hygiene; oral infections and decreased saliva production. Symptoms include fever, dehydration, chills, fast heartbeat and breathing if the infection is causing sepsis. Medications such as antihistamines and diuretics can be predisposing factors. Treatment is usually antibiotics. Parotitis as Extrapulmonary Tuberculosis: The mycobacterium that cause tuberculosis can also cause parotid infection. Parotid swelling can be an uncommon symptom of extrapulmonary tuberculosis (TB outside of the lungs). The usual symptoms are a cough, fever, weight loss, shortness of breath, chest pain, tiredness and chills. This is caused by the bacteria Mycobacterium tuberculosis. TB can also affect the heart, thyroid and adrenal glands but the main site of infection is the lungs. Risk factors are chronic alcohol consumption, diabetes, long term steroid use, HIV infection and kidney failure. Those infected tend to have enlarged, nontender, but moderately painful glands. The diagnosis is made by typical chest radiograph findings, cultures, or histologic diagnosis after the gland has been removed. When diagnosed and treated with antitubercular medications, the gland may return to normal in 1–3 months. Acute viral parotitis (mumps):The most common viral cause of parotitis is mumps. Routine vaccinations have dropped the incidence of mumps to a very low level. Mumps resolves on its own in about ten days. A viral infection caused by Paramyxovirus, a single-stranded RNA virus. Common symptoms include fever, headache and bilateral or unilateral parotitis (swelling of the parotid gland on one or both sides of the face). The parotid gland is usually swollen and tender. Parotid swelling usually occurs 16–18 days after exposure to the virus. Treatment includes isolation and therefore prevention of spread of the disease and supportive measures such as hot or cold packs. Mumps usually resolves itself and can be prevented by vaccination. HIV parotitis: Generalized lymphadenopathy has long been associated with HIV, but the localized enlargement of the parotid gland is less well known. HIV-associated salivary gland disease can involve many diseases but often presents as enlargement of the parotid gland and a dry mouth. Causes have not been specifically identified but the most likely are viral opportunists and autoimmune responses. Viruses linked to this can include; hepatitis C, cytomegalovirus, paramyxovirus, influenza A and adenovirus. Treatment is anti-retroviral therapy.